Download Current Oncology Editorial Forty-nine percent of Canada`s Inuit

Current Oncology Editorial
Forty-nine percent of Canada’s Inuit resides in Nunavut. Factors such as geographic isolation and the
Inuit’s distinct culture have a unique impact on cancer epidemiology among this population and create
an area ripe for investigation. Dr. Tim Asmis and his colleagues completed an eleven-year retrospective
study on cancer treatment and outcomes of Inuit patients referred from Nunavut to The Ottawa
Hospital Cancer Centre (TOHCC) as a hub of the Champlain Regional Cancer Program. This study is the
first of its kind and provides valuable information about an often overlooked population.
TOHCC provides cancer care for patients from the Baffin region of Nunavut. Patients from Nunavut
travel over 2000km by air to Ottawa for multidisciplinary assessment, treatment and follow-up for all
malignant conditions. Coordination of culturally sensitive care is extremely important for those who
come to Ottawa because interpreters, housing and transportation are needed to accommodate these
patients.
TOHCC not only serves the Inuit population from Nunavut, but also serves a substantial Inuit
population that resides in the Ottawa region. In fact, Ottawa is home to the greatest number of Inuit
outside of the North (1) and the region has the third largest Aboriginal population in Ontario.
“Aboriginal” is an umbrella term that refers to three distinct groups: First Nations, Metis, and Inuit
(FNIM). Each group has its own customs, language, beliefs, values and certainly differing health
needs. There are approximately 38,000 Aboriginal peoples living in the Ottawa area, and this number is
growing rapidly (2). From 2001-2006, the population grew by 67%, six times the non-Aboriginal
population (3) due to higher birth rates and more people moving to urban areas (4). First Nations make
up the greatest proportion of Aboriginals in the Ottawa area, followed by Metis and the Inuit.
Aboriginals deserve greater attention in the area of cancer care because FNIM communities have
increased incidences of cancer, later stage cancer diagnoses, and lower survival rates than the general
population (4). In fact, the Inuit have the highest rate of lung cancer in the world (5).
The provincial government, namely Cancer Care Ontario (CCO), has recognized the need to better serve
FNIM patients and is committed to reducing cancer cases among FNIM people and ensuring those who
do get cancer receive timely and culturally-appropriate access to services. CCO launched the Aboriginal
Cancer Strategy II (ACS II) in June 2012, and has been working to achieve key milestones across each of
its six strategic priorities: Building Productive Relationships, Research and Surveillance, Prevention,
Screening Blitz, Palliative and Supportive Care and Education (5). In executing the strategy, CCO is
working in partnership with TOHCC to develop strong relationships with community partners and to
support locally-driven solutions and to position ourselves for the upcoming ACSIII.
The Champlain Regional Cancer Program has enhanced the care for the aboriginal population through
the introduction of an Aboriginal Patient Coordinator who provides support in navigating the cancer
system and addresses cultural and spiritual needs. Patients also have access to new designated space in
the Cancer Centre that is welcoming, and culturally-appropriate. Volunteers from the FNIM communities
were very active in designing the space and participated in a special event to mark the opening.
Specifically for the Inuit community, the TOHCC collaborates with the Ottawa Health Services INC (OSNI)
to assist in the care of residents of Baffin coming to Ottawa for health care and with Larga Baffin, an
organization that provides culturally sensitive lodging, meals and transportation for patients from
Nunavut. TOHCC is actively pursuing improvements in cancer care in Nunavut. For example a CT
scanner was recently installed in Iqaluit and physicians are now able to read images and diagnose
remotely from Ottawa. TOHCC has also formed a working group to assist in collaboratively designing
priorities in improvement of the provision of cancer care from prevention through treatment to
survivorship and palliative care. With the support of researchers, government and the community,
TOHCC is working diligently to build the foundation for what will be a long-term commitment to
improving Aboriginal health.
Paula Doering, Vice President, Clinical Programs and Champlain Regional Cancer Program
Cathy DeGrasse, Clinical Director, Champlain Regional Cancer Program
The Ottawa Hospital
501 Smyth Road,
Ottawa, ON,
K1H 8L6
References
1. Champlain LHIN. Aboriginal Demographics. 2013.
2. Statistics Canada. NHS Profile, Ottawa - Gatineau (Ontario part), CMA, Ontario, 2011 . Statistics
Canada. [Online] [Cited: Sept 22, 2013.] http://www12.statcan.gc.ca/nhs-enm/2011/dppd/prof/details/page.cfm?Lang=E&Geo1=CMA&Code1=50535&Data=Count&SearchText=ottawa&Searc
hType=Begins&SearchPR=01&A1=Aboriginal%20peoples&B1=All&Custom=&TABID=1.
3. City of Ottawa. Equity and Inclusion Lens: Diversity Snapshot, Aboriginal Peoples. 2010.
4. Champlain Regional Cancer Program. Aboriginal Cancer Screening Toolkit. 2013.
5. Cancer Care Ontario. Aboriginal Cancer Strategy II. 2012.